全凭静脉麻醉下腹腔镜手术对异位妊娠术后妊娠结局的影响
[Effect of laparoscopic surgery under total intravenous anesthesia on postoperative pregnancy outcomes of heterotopic pregnancies].
作者信息
Shi Chengmei, Jia Donglin, Song Xueling, Guo Xiangyang, Li Chen
机构信息
Department of Anesthesiology, Peking University Third Hospital, Beijing 100191, China.
出版信息
Zhonghua Yi Xue Za Zhi. 2016 Jan 26;96(4):293-6. doi: 10.3760/cma.j.issn.0376-2491.2016.04.014.
OBJECTIVE
To evaluate the effects of laparoscopic surgery under total intravenous anesthesia (TIVA) on outcomes of heterotopic pregnancies which need to receive laparoscopic procedures.
METHODS
The data of 108 cases of pregnant women in Center of Reproductive Medicine, Peking University Third Hospital were retrospectively analyzed, and divided into two groups according to whether received surgery. Surgery group : 48 pregnant women after in vitro fertilization-embryo transfer (IVF-ET) were diagnosed as heterotopic pregnancies and received laparoscopic procedures under TIVA.
CONTROL GROUP
60 normal pregnant women after IVF-ET. The miscarriage rate, pregnant complications rate, premature birth rate, live birth rate, delivery weeks and cesarean section rate of two groups were compared. Meanwhile, the newborn's weight, male rate, birth defect rate and Apgar score in 1 min and 5 min of the two groups were compared.
RESULTS
The miscarriage rate, pregnant complications rate, premature birth rate, cesarean section rate, male rate of surgery group were 14.6%, 16.7%, 4.2%, 82.9%, 51.2% respectively, which were 15.0%, 18.3%, 6.7%, 84.3%, 52.9% in control group respectively. There were no significant difference between the two groups (χ(2)=-0.072, -0.241, -0.569, -0.442, -0.163, P>0.05). The delivery weeks and newborn's weight of surgery group were (38.3±1.7)weeks and(3 394.9±460.7)g respectively , which were (37.9±1.5) weeks and (3 406.3±512.6 )g in control group. There were no significant difference between the two groups (t=1.083, -0.111, P>0.05). The 1 min Apgar score and 5 min Apgar score of surgery group were 9.6(9.0-10.0), 10(10-10) scores and were 9.5(9.0-10.0), 10(10-10) scores in control group.There were no significant difference between the two groups (Z=-0.418, 0.000, P>0.05). The live birth rate of two groups were both 100%, and the birth defect rate were both 0.
CONCLUSION
Laparoscopic surgery under TIVA has no effect on the outcome of heterotopic pregnancies.
目的
评估全凭静脉麻醉（TIVA）下的腹腔镜手术对需要接受腹腔镜手术的异位妊娠结局的影响。
方法
回顾性分析北京大学第三医院生殖医学中心108例孕妇的数据，并根据是否接受手术分为两组。手术组：48例体外受精-胚胎移植（IVF-ET）后被诊断为异位妊娠并在TIVA下接受腹腔镜手术的孕妇。
对照组
60例IVF-ET后的正常孕妇。比较两组的流产率、妊娠并发症发生率、早产率、活产率、分娩孕周和剖宫产率。同时，比较两组新生儿的体重、男婴比例、出生缺陷率以及1分钟和5分钟时的阿氏评分。
结果
手术组的流产率、妊娠并发症发生率、早产率、剖宫产率、男婴比例分别为14.6%、16.7%、4.2%、82.9%、51.2%，对照组分别为15.0%、18.3%、6.7%、84.3%、52.9%。两组之间差异无统计学意义（χ(2)=-0.072，-0.241，-0.569，-0.442，-0.163，P>0.05）。手术组的分娩孕周和新生儿体重分别为（38.3±1.7）周和（3394.9±460.7）g，对照组分别为（37.9±1.5）周和（3406.3±512.6）g。两组之间差异无统计学意义（t=1.083，-0.111，P>0.05）。手术组1分钟和5分钟时的阿氏评分分别为9.6（9.0-10.0）、10（10-10）分，对照组分别为9.5（9.0-10.0）、10（10-10）分。两组之间差异无统计学意义（Z=-0.418，0.000，P>0.05）。两组的活产率均为100%，出生缺陷率均为0。
结论
TIVA下的腹腔镜手术对异位妊娠结局无影响。
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